Disposable

As a third-year medical student, I was two weeks into my trauma-surgery rotation when my resident casually called me “disposable.” I wasn’t offended—in fact, the word perfectly described how I’d been feeling. I also understood that it was no reflection on my performance; rather, it was a commentary on medical students in general.

Surgery was the first rotation of my third year—and, now that the COVID pandemic was winding down, it was also my first in-person clinical rotation.

I’d never been on the floors of the hospital. I felt clueless, underprepared and incompetent. I constantly got lost running around the hospital floors. The highlights of my surgery rotation so far had included never getting my fingers into the right holes of the surgical gloves, accidentally following residents into the bathroom and mistakenly clapping at a morbidity-and-mortality meeting.

As a member of the trauma team, I’d quickly learned that my job was to stay out of the way, especially during the most critical emergencies. Occasionally I’d fetch a warm blanket for a patient, and one time I even got to use the trauma shears to cut off a patient’s clothing. During surgeries, I felt completely superfluous. After one scrub technician had taught me how to scrub in, a different scrub tech yelled at me for breaking sterility before I’d even taken the first step in washing my hands.

I felt keenly aware that I was more of a burden than a help—and I had no reason to believe that my other rotations would go differently. Not until my internal-medicine rotation, two months later, did I realize that this might not be true. I was assigned to the geriatrics/palliative-care team—my first experience with this kind of care. The first day, the attending told me to go down to the emergency department, do a complete history and physical on a patient named Mr. Knight, then present this information during rounds.

Seeing the look on my face, the attending paused.

“Just go see the patient,” he said calmly.

After quieting my heart rate and glancing at the patient’s chart, I went down to the crowded ED and found Mr. Knight on a gurney in a hallway.

I introduced myself and asked, “What brings you to the hospital today?”

His answer was mostly gestures and faltering utterances: “I…I…fell…my…s-s-s-on’s house…trying to…clean.”

I felt a little uncomfortable, because he was having such trouble communicating, and I couldn’t immediately assess his cognitive status. The lack of privacy didn’t help: I grabbed a mobile curtain and pulled it to encircle us.

Thinking back to Mr. Knight’s chart, I remembered that he was a stroke victim with aphasia. Rounds wouldn’t start for an hour, so I sat with him while he told me his story.

It soon became apparent that he was mentally intact—and, to my relief, that he had a good sense of humor. He also wanted to know more about me.

“What do you like to do?” he asked. “How many more years of school do you have left?” He made jokes about his fall and asked me for the hospital wifi password so that he could place his sports bets. At one point, he stopped in midsentence, then said, “I’m sorry, I find it hard to multitask.”

He clearly found his aphasia frustrating, but I waited, not interrupting, while he struggled to find words. For my part, I felt grateful that he wasn’t annoyed at me for asking the same questions that patients get asked repeatedly—questions that seem to have nothing to do with their chief complaint.

“I’ll be back later today with the rest of my team,” I said, getting ready to leave. “I’ll present your case to them.”

When our team walked into Mr. Knight’s room, he looked past the doctors and residents and right at me. “Bobbi!” he exclaimed, to my shock. In this academic hospital, I’d noticed, the patients saw so many doctors, nurses and students that they either couldn’t remember people’s names or gave up trying. It felt really nice that Mr. Knight remembered me—as if our time together had made a difference to him.

This feeling sustained me through the nerve-wracking process of presenting his case to the team, and during their discussion of his treatment, which included surgery the following morning.

Later my resident said, “Your patient told me that he really appreciated your taking the time to talk to him in the ED.”

“Your patient…” I savored those words. This was the first time I felt I could legitimately use that phrase. I wouldn’t go so far as to say that I was “nondisposable,” but I began to see that, as a insignificant medical student, I might have one thing to offer Mr. Knight that my team’s interns, residents and attendings did not.

I didn’t make any of Mr. Knight’s medical decisions or perform his operation, but I took the time to listen to his story and get to know him as a person.

After his surgery, I saw him in the post-anesthesia care unit, and every morning on rounds for the next five days. I saw him take his first steps after surgery, and I was there to hear him say proudly, “I just walked all the way down the hallway.” Each night, I made sure to stop by his room before leaving the hospital.

Although I didn’t yet know how to treat Mr. Knight’s symptoms, I did come to know that he’s a baker who likes to bet on sports. For me, that was a win.

When he was discharged, I felt both happy and sad—happy because he was well enough to go to rehab, and sad because I’d made a friend, and he was leaving. I knew that he had so much more to say to me.

Walking with him to the parking lot, I couldn’t help wondering what was in store for him. When we arrived at his car, he hugged me goodbye. I can only hope that the people who care for him in future will be lucky enough to have the time to get to know him as well as I did.

And I keep thinking about those words: “Just go see the patient.”

Just going to see Mr. Knight taught me two vital lessons. First, that it is truly a privilege to listen to a patient’s story and help with their care. And second, that although as a medical student I might be disposable, I do have one thing that I consider nondisposable, even precious—and that is my time.